Worker Interview - DSA

Worker Interview

General Information

Project Name: HSPVA - HISD

Prime Contractor: McCarthy Building Company

Subcontrctor: J.M. Maly, Inc.

Interview Detail

Date

Worker Name

Auditor Name

Remarks

06/26/2018 09:13 AM

Ernesto Perez

Austin Jonas

Just started today

ethnicity

gender

ssn

badge

Hispanic

Male

5159

Yes

Job Classification

Union Member?

Apprentice?

Period

Laborer-Semi Skilled/Helper

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

06/26/2018

06/26/2018

8.00

13.00

Pay Type

Pay Day

deductions

OSHA

Debit

Friday

No

Yes-10

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Hand Tools

Ladder

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

0.00

Other Work?

Other Training?

Experience

Certifications

None

None

4.00

Forklift, boomlift, etc w/ company

Aware of Postings?

Threatened?

Yes

No

Signatures

Employee Signature

Auditor Signature